The Association’s American Health Policy Institute submitted policy recommendations to a House Education and Labor subcommittee hearing on ways to improve access to behavioral health care services, an issue which continues to challenge employers.
The HR Policy and AHPI recommendations included:
- Increasing federal funding to encourage behavioral health providers to practice in Professional Shortage Areas;
- Requiring health care providers and facilities to notify the group health plan or issuer whether they are accepting new patients;
- Integrating behavioral health and primary care through a collaborative care model and improving measurement-based care; and
- Expanding telebehavioral health services.
Provider witness recommendations included:
- Adding civil monetary penalties for employer mental health parity violations;
- Requiring employer plans to reimburse telebehavioral health services, including those services furnished via audio-only communication, at the same rate as in-person services;
- Requiring plan medical necessity determinations to comport with generally accepted standards of clinical practice;
- Protecting plan participants from cost-sharing that exceeds their in-network financial responsibility when out-of-network services must be sought due to network inadequacy; and
- Making third-party claims administrators ERISA fiduciaries.
Separately, the latest Mental Health Index found employees ages 40-59 have experienced worrisome declines in mental health over the last few months and general anxiety is 86% higher than before the pandemic. There is some reason for optimism, however, as the data for women across all age groups are showing notable improvements.
Outlook: House Education and Labor Committee chair, Rep. Bobby Scott seems prepared to move forward with Rep. Norcross's bill (H.R. 1364) to create civil monetary penalties for employer plans that violate mental health parity requirements.